Sandwich assay for small molecules

ABSTRACT

Methods are disclosed for a sandwich assay for a small molecule having a molecular weight of about 500 to about 2,500. The method comprises the use of a first antibody that binds to the small molecule and a second antibody that binds to the small molecule at a portion of the small molecule other than a portion to which the first antibody binds. The second antibody is prepared from an immunogen that comprises a hapten that is not the small molecule or a derivative of the small molecule wherein the hapten comprises a moiety that is structurally similar to that of the second portion of the small molecule. The antibodies may be employed in sandwich assays for the small molecule.

The subject application claims benefit under 35 USC § 119(e) of U.S.Provisional Application No. 62/247,970, filed Oct. 29, 2015. The entirecontent of the above-referenced patent application is hereby expresslyincorporated herein by reference.

BACKGROUND

The invention relates to compounds, methods and kits for thedetermination of small molecules, in samples, such as patient samples,known or suspected to contain one or more of such small molecules. Insome aspects the invention relates to sandwich assays for smallmolecules such as, for example, immunosuppressant drugs.

The body relies upon a complex immune response system to distinguishself from non-self. At times, the body's immune system must becontrolled in order to either augment a deficient response or suppressan excessive response. For example, when organs such as kidney, heart,heart-lung, bone marrow and liver are transplanted in humans, the bodywill often reject the transplanted tissue by a process referred to asallograft rejection.

In treating allograft rejection, the immune system is frequentlysuppressed in a controlled manner with drug therapy. Immunosuppressantdrugs are therapeutic drugs that are carefully administered totransplant recipients in order to help prevent allograft rejection ofnon-self tissue. Immunosuppressive drugs can be classified as follows:glucocorticoids, cytostatics, antibodies, drugs acting on immunophilins,and other drugs such as interferons, opiates INF binding proteins,mycophenolate, FTY720 and the like. A particular class ofimmunosuppressant drugs comprises those drugs that act on immunophilins.Immunophilins are an example of high-affinity, specific binding proteinshaving physiological significance. Two distinct families ofimmunophilins are presently known: cyclophilins and macrophilins, thelatter of which specifically bind, for example, tacrolimus or sirolimus.

Two most commonly administered immunosuppressive drugs to prevent organrejection in transplant patients are cyclosporine (CSA) and FK-506 (FKor tacrolimus). Another drug that finds use as an immunosuppressant inthe United States and other countries is sirolimus, also known asrapamycin. Derivatives of sirolimus are also useful asimmunosuppressants. Such derivatives include, for example, everolimus,and the like.

The side effects associated with some immunosuppressant drugs can becontrolled in part by carefully controlling the level of the drugpresent in a patient. Therapeutic monitoring of concentrations ofimmunosuppressant drugs and related drugs in blood is required tooptimize dosing regimes to ensure maximal immunosuppression with minimaltoxicity. Although immunosuppressant drugs are highly effectiveimmunosuppressive agents, their use must be carefully managed becausethe effective dose range is often narrow and excessive dosage can resultin serious side effects. On the other hand, too little dosage of animmunosuppressant can lead to tissue rejection. Because distribution andmetabolism of an immunosuppressant drug can vary greatly betweenpatients and because of a wide range and severity of adverse reactions,accurate monitoring of the drug level is essential. Assays foraccurately monitoring drug level in patients are subject tocross-reactivity with drug analogs such as metabolites, which interferewith accurate measurement of drug level in a patient.

There is, therefore, a continuing need to develop fast and accuratediagnostic methods to measure levels of small molecules such as, forexample, immunosuppressant drugs or derivatives thereof in patients. Themethods should be capable of being fully automated and shouldselectively detect the parent molecule while minimizing inaccuraciesresulting from the cross-reactivity of its metabolites or fromconstituents in a sample suspected of containing the small molecule.

SUMMARY

Some examples in accordance with the principles described herein aredirected to methods of determining a presence and/or amount of a smallmolecule having a molecular weight of about 500 to about 2,500 in asample suspected of containing the small molecule. A combination thatcomprises the sample, a first binding partner that binds to and isspecific for a first portion of the small molecule, and a second bindingpartner that binds to the small molecule at a second portion of thesmall molecule other than the first portion is formed in a medium. Thesecond binding partner is prepared from an immunogen that comprises ahapten that is not the small molecule or a derivative of the smallmolecule. The hapten of the immunogen comprises a moiety that isstructurally similar to that of the second portion of the smallmolecule. The medium is incubated under conditions for binding of thefirst binding partner and the second binding partner to the smallmolecule. The medium is examined for the presence of an immunocomplexcomprising the small molecule, the first binding partner and the secondbinding partner, the presence and/or amount of the immunocomplexindicating the presence and/or amount of the small molecule in thesample.

Some examples in accordance with the principles described herein aredirected to methods of determining a presence and/or amount of animmunosuppressant drug in a sample suspected of containing theimmunosuppressant drug. The method comprises providing in combination ina medium (i) the sample, (ii) a first antibody that binds to and isspecific for a first portion of the immunosuppressant drug, and (iii) asecond antibody that binds to the immunosuppressant drug at a secondportion of the immunosuppressant drug other than the first portion. Thesecond antibody is prepared from an immunogen that comprises a haptenthat is not the immunosuppressant drug or a derivative thereof. Thehapten of the immunogen comprises a moiety that is structurally similarto that of the second portion of the immunosuppressant drug. The mediumis incubated under conditions for binding of the first antibody and thesecond antibody to the immunosuppressant drug. The medium is examinedfor the presence of an immunocomplex comprising the immunosuppressantdrug, the first antibody and the second antibody, the presence and/oramount of the immunocomplex indicating the presence and/or amount of theimmunosuppressant drug in the sample.

Some examples in accordance with the principles described herein aredirected to methods of determining a presence and/or amount of animmunosuppressant drug selected from the group consisting of sirolimusor everolimus in a sample suspected of containing the immunosuppressantdrug. A combination is formed in a medium wherein the combinationcomprises the sample, a first monoclonal antibody that binds to and isspecific for a first portion of the immunosuppressant drug, and a secondmonoclonal antibody that binds to the immunosuppressant drug at a secondportion of the immunosuppressant drug other than the first portion,wherein the second monoclonal antibody is prepared from an immunogenthat comprises tacrolimus or a derivative of tacrolimus. The medium isincubated under conditions for binding of the first monoclonal antibodyand the second monoclonal antibody to the immunosuppressant drug. Themedium is examined for the presence of an immunocomplex comprising theimmunosuppressant drug, the first antibody and the second antibody, thepresence and/or amount of the immunocomplex indicating the presenceand/or amount of the immunosuppressant drug in the sample.

BRIEF DESCRIPTION OF THE DRAWINGS

The drawings provided herein are not to scale and are provided for thepurpose of facilitating the understanding of certain examples inaccordance with the principles described herein and are provided by wayof illustration and not limitation on the scope of the appended claims.

FIG. 1 is a chemical formula for sirolimus (I).

FIG. 2 is a chemical formula for everolimus (II).

FIG. 3 is a chemical formula for tacrolimus (III).

FIG. 4 is the chemical formula of FIG. 1 with numbering and depictingportions of the molecule to which monoclonal antibodies can be preparedin accordance with the principles described herein.

FIG. 5 is the chemical formula of FIG. 3 depicting a portion of thetacrolimus molecule that is structurally similar to that of a portion ofsirolimus and of everolimus.

FIG. 6 is a reaction scheme for the preparation of oxime derivatives ofsirolimus.

FIG. 7 is a reaction scheme for the preparation of an immunogen from anoxime derivative of sirolimus of FIG. 6.

DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS General Discussion

The present inventors have discovered that binding partners such as, forexample, antibodies, can be designed that specifically bindsimultaneously to separate portions of small molecules. This discoveryis surprising because small molecules are haptens, which are relativelysmall molecules (molecular weight (daltons) less than about 2,500, orless than about 2000, or less than about 1500, or less than about 1000)and are not considered to have more than one site to which an antibodycan bind. In accordance with the principles described herein, at leasttwo different binding partners can be prepared, which bind to separateportions of a small molecule at the same time. The first binding partnerbinds to and is specific for a first portion of the small molecule. Thesecond binding partner binds to the small molecule at a second portionof the small molecule other than the first portion, wherein the secondbinding partner is prepared from an immunogen that comprises a haptenthat is not the small molecule or a derivative of the small molecule andwherein the hapten of the immunogen comprises a moiety that isstructurally similar to that of the second portion of the smallmolecule.

The term “small molecule” refers to a molecule having a molecular weightof about 150 to about 2,500, or about 150 to about 2,000, or about 150to about 1,500, or about 150 to about 1,000, or about 150 to about 500,or about 300 to about 2,000, or about 300 to about 1,500, or about 300to about 1,000, or about 500 to about 2,000, or about 500 to about1,500, or about 500 to about 1,000, for example. For the most part,small molecules do not elicit an immune response by themselves.

The phrase “binding partner for a small molecule” refers to a moleculethat binds specifically to the small molecule and does not bind to anysignificant degree to other substances that would distort the analysisfor the small molecule. Furthermore, the binding partner for the smallmolecule binds specifically to a certain domain of the small molecule.Specific binding involves the specific recognition of one of twodifferent molecules, or two different domains of a small molecule, forthe other compared to substantially less recognition of other moleculesor other domains of a small molecule. On the other hand, non-specificbinding involves non-covalent binding between molecules that isrelatively independent of specific surface structures. Non-specificbinding may result from several factors including hydrophobicinteractions between molecules. The binding partners may be, but are notlimited to, antibodies including monoclonal antibodies, receptors formolecules with similar chemical structures, plasma transporter proteinssuch as albumin, and lipoproteins, for example.

The phrase “antibody for a small molecule” refers to an antibody thatbinds specifically to the small molecule and does not bind to anysignificant degree to other substances that would distort the analysisfor the small molecule. Furthermore, the antibody for the small moleculebinds specifically to a certain portion or domain of the small molecule.

A small molecule, to which examples in accordance with the principlesdescribed herein may be applied, has spatially separate binding domainsfor the antibodies. The small molecule may be linear or it may compriseone or more rings, for example, two rings, or three rings, or fourrings, or five rings, or more. The binding domains on the small moleculeshould be separated such that two different binding partners can bindsimultaneously to the small molecule without interfering with thebinding of each other to form a three-member complex (or immunocomplex)wherein each binding partner binds to an extent necessary so that asufficiently stable complex is formed comprising the two bindingpartners and the small molecule. The complex is considered sufficientlystable when the complex remains intact during an assay so that thecomplex can be detected and the amount of the complex accuratelyreflects the amount of a small molecule analyte in a sample. The stablecomplex permits an accurate and sensitive assay for the small moleculeanalyte.

In some examples the small molecule comprises at least one large ring,which is a 15-50 membered ring, or a 15-45 membered ring, or a 15-40membered ring, or a 15-35 membered ring, or a 15-30 membered ring, or a15-25 membered ring, or a 15-20 membered ring, or a 20-50 membered ring,or a 20-45 membered ring, or a 20-40 membered ring, or a 20-35 memberedring, or a 20-30 membered ring, or a 20-25 membered ring, or a 25-50membered ring, or a 25-45 membered ring, or a 25-40 membered ring, or a25-35 membered ring, or a 25-30 membered ring, or a 30-50 membered ring,or a 30-45 membered ring, or a 30-40 membered ring, for example. Theatoms forming the ring are primarily carbon and may also include, butare not limited to, oxygen, nitrogen and sulfur, for example. The largering may also comprise 1-5, or 1-4, or 1-3 or 1-2, or 2-5, or 2-4, or2-3, small rings, which are 5-7 membered rings or 5-6 membered rings.Some of the atoms of the small rings may be part of the large ring.

In some examples, the small molecule comprises a three dimensionalconformation with one or more unique chemical functional groups thatallow different binding partners to be prepared where at least twodifferent binding partners can approach and bind to different bindingdomains on the small molecule without interfering with one another. Theunique chemical functional groups include, by way of illustration andnot limitation, carbon-carbon double bonds, carbon-carbon triple bonds,carbonyl groups, imine groups, carboxyl groups, hydroxyl groups, aminegroups, amide groups, ester groups and ether groups, for example, andcombinations of two or more of the above. The chemical functional groupsmay be unconjugated or conjugated. The term “conjugated” refers tocontiguous atoms that have available p-orbitals such that electrons canbe delocalized over the contiguous atoms. Examples of conjugated atomsinclude, but are not limited to, one, two, three, four, or five or moreconjugated carbon-carbon double bonds (vinyl groups); one, two, three,four, or five or more conjugated carbon-carbon triple bonds; acombination of one, two, three, four, or five or more conjugatedcarbon-carbon double bonds, carbon-carbon triple bonds, imine groups,carbonyl groups, and anions, for example. In some examples, the chemicalfunctional groups provide a particular spatial conformation for thesmall molecule.

In some examples the small molecule is a macrolide. In some examples themacrolide is an immunosuppressant drug. The term “immunosuppressantdrugs” includes those that act on immunophilin such as, but not limitedto, cyclosporin (including cyclosporin A, cyclosporin B, cyclosporin C,cyclosporin D, cyclosporin E, cyclosporin F, cyclosporin G, cyclosporinH, cyclosporin I), tacrolimus (FR-900506, FK506, PROGRAF®), sirolimus(rapamycin, RAPAMUNE®), and derivatives of the above such as, but notlimited to, Everolimus (RAD, CERTICAN®), for example.

As mentioned above, some examples in accordance with the principlesdescribed herein are directed to methods of designing antibodies for asandwich assay for a small molecule having a molecular weight of about500 to about 2,500. The method comprises preparing a first antibody thatbinds to a portion or domain of the small molecule, and preparing asecond antibody that binds to the small molecule at a portion or domainof the small molecule other than a portion or domain to which the firstantibody binds. The second antibody is prepared from an immunogen thatcomprises a hapten that is not the small molecule or a derivative of thesmall molecule where the hapten comprises a moiety that is structurallysimilar to that of the second portion of the small molecule.

The phrase “structurally similar” means that one moiety has the same orsimilar structural or spatial characteristics as another moiety suchthat both moieties exhibit a binding affinity to an antibody that is atleast 10⁵ liters per mole, or least 10⁶ liters per mole, or least 10⁷liters per mole, or least 10⁸ liters per mole, or least 10⁹ liters permole, for example. In some examples, an antibody exhibits substantiallythe same binding affinity to each moiety, which means that the bindingaffinity of one moiety for the antibody does not differ from the bindingaffinity for the other moiety by more than 10³, or by more than 10², orby more than 10, for example.

The phrase “hapten that is not the small molecule” refers to a compoundother than small molecule or other than a derivative of the smallmolecule. The phrase “derivative of the small molecule” refers to asmall molecule that is modified by formation of an ester, an amide, oran ether, for example, or is modified by hydrolysis of an ester, anamide, or an ether, for example. The hapten that is not the smallmolecule comprises a moiety that is structurally similar to that of theportion (second portion) of the small molecule other than the portion ofthe small molecule to which the first antibody binds. In some examplesthe small molecule is sirolimus or everolimus and the hapten of theimmunogen that is not the small molecule is, by way of illustration andnot limitation, tacrolimus or a derivative of tacrolimus, for example.The immunogen comprises the hapten that is not the small molecule linkedto an immunogenic carrier and may be used in preparing antibodies inaccordance with the principles described herein.

Preparation of monoclonal antibodies that simultaneously bind to twodifferent domains on a small molecule enables the use of such antibodiesin sandwich assays in which the small molecule is simultaneously boundby the two different antibodies to form an immunocomplex. The ability toperform sandwich assays on small molecules enhances the sensitivity ofan assay for the small molecule. In addition, in the case of sandwichassays involving one monoclonal antibody bound to a support, the assaymay be conducted in the presence of impurities and interferingsubstances of a sample because the support can be separated from thesample and washed after small molecule has been allowed to bind to themonoclonal antibody of the support but before introduction of the secondmonoclonal antibody.

Antibodies may include a complete immunoglobulin or fragment thereof,which immunoglobulins include the various classes and isotypes, such asIgA, IgD, IgE and IgM, for example. Fragments thereof may include Fab,Fv and F(ab′)₂, Fab′, for example. In addition, aggregates, polymers,and conjugates of immunoglobulins or their fragments can be used whereappropriate so long as binding affinity for a particular molecule ismaintained.

Antibodies in accordance with the principles described herein may beprepared by techniques including, but not limited to, immunization of ahost and collection of sera (polyclonal), preparing continuous hybridcell lines and collecting the secreted protein (monoclonal) or cloningand expressing nucleotide sequences or mutagenized versions thereofcoding at least for the amino acid sequences required for specificbinding of natural antibodies, for example.

Monoclonal antibodies can be prepared by techniques that are well knownin the art such as preparing continuous hybrid cell lines and collectingthe secreted protein (somatic cell hybridization techniques). Monoclonalantibodies may be produced according to the standard techniques ofKohler and Milstein, Nature 265:495-497, 1975. Reviews of monoclonalantibody techniques are found in Lymphocyte Hybridomas, ed. Melchers, etal. Springer-Verlag (New York 1978), Nature 266: 495 (1977), Science208: 692 (1980), and Methods of Enzymology 73 (Part B): 3-46 (1981).

In another approach for the preparation of antibodies, the sequencecoding for antibody binding sites can be excised from the chromosome DNAand inserted into a cloning vector, which can be expressed in bacteriato produce recombinant proteins having the corresponding antibodybinding sites. This approach involves cloning and expressing nucleotidesequences or mutagenized versions thereof coding at least for the aminoacid sequences required for specific binding of natural antibodies.

In one approach for the production of monoclonal antibodies, a firststep includes immunization of an antibody-producing animal such as amouse, a rat, a goat, a sheep, or a cow with an immunogen in accordancewith the principles described herein.

Immunization can be performed with or without an adjuvant such ascomplete Freund's adjuvant or other adjuvants such as monophosphoryllipid A and synthetic trehalose dicorynomycolate adjuvant. A next stepincludes isolating spleen cells from the antibody-producing animal andfusing the antibody-producing spleen cells with an appropriate fusionpartner, typically a myeloma cell, such as by the use of polyethyleneglycol or other techniques. Typically, the myeloma cells used are thosethat grow normally in hypoxanthine-thymidine (HT) medium but cannot growin hypoxanthine-aminopterin-thymidine (HAT) medium, used for selectionof the fused cells. A next step includes selection of the fused cells,typically by selection in HAT medium. A next step includes screening thecloned hybrids for appropriate antibody production using immunoassayssuch as enzyme-linked immunosorbent assay (ELISA) or other immunoassaysappropriate for screening.

An antibody (prepared from an immunogen in accordance with theprinciples described herein) with the requisite specificity may beselected by screening methodologies, which include, by way ofillustration and not limitation, ELISA, dot blots, Western analysis, andSurface Plasmon Resonance, for example. In this manner an antibody isobtained that binds to a domain of a small molecule of interest and doesnot bind to any detectable degree to other domains of the small moleculeor to other molecules that are not of interest in a particular assay. Insome examples in accordance with the principles described herein, anantibody that binds to a domain of a small molecule of interest has abinding affinity for the domain of the small molecule of interest ofabout 10⁷ to about 10¹⁴ liters/mole, or about 10⁷ to about 10¹¹liters/mole, or about 10⁷ to about 10¹² liters/mole, or about 10⁸ toabout 10¹⁴ liters/mole, or about 10⁸ to about 10¹¹ liters/mole, or about10⁸ to about 10¹² liters/mole, for example. The phrase “any detectabledegree” means that the antibody that specifically binds to a domain of asmall molecule of interest has a binding affinity for other domains ofthe small molecule of interest or for other molecules that are not ofinterest of less than about 10⁴ liters/mole, or less than about 10³liters/mole, or less than about 10² liters/mole, or less than about 10liters/mole, for example.

The term “hapten” refers to compounds that do not elicit an immuneresponse unless linked to large molecule or immunogenic carrier thatdoes illicit an immune response in order to raise antibodies. Haptensare compounds capable of binding specifically to correspondingantibodies, but do not themselves act as immunogens (or antigens) forpreparation of the antibodies. Haptens have a molecular weight of about150 to about 2,500.

The term “immunogenic carrier” means a group or moiety which, whenconjugated to a hapten and injected into a mammal or otherwise employedas an immunogen, induces an immune response and elicits production ofantibodies that bind to the hapten. Immunogenic carriers are alsosometimes referred to as antigenic carriers. In some examples inaccordance with the principles described herein, immunogens comprisingimmunogenic carriers, including poly(amino acid) and non-poly(aminoacid) immunogenic carriers, linked to a small molecule at a particularposition are synthesized and used to prepare antibodies in accordancewith the principles described herein.

The molecular weight range (in Daltons) for poly(amino acids) that areimmunogenic carriers is about 5,000 to about 10,000,000, or about 20,000to about 600,000, or about 25,000 to about 250,000 molecular weight, forexample. Poly(amino acid) immunogenic carriers include proteins such as,for example, albumins, serum proteins, e.g., globulins, ocular lensproteins and lipoproteins. Illustrative proteins include, but are notlimited to, bovine serum albumin (BSA), keyhole limpet hemocyanin (KLH),egg ovalbumin, and bovine gamma-globulin (BGG), thyroglobulin, ovalbuminor fibrinogen, for example. In one illustrative example, the protein isKLH; in another illustrative example, the protein is BSA. Non-poly(aminoacid) immunogenic carriers include polysaccharides, nucleic acids andparticles (biologic and synthetic materials). A wide variety ofimmunogenic carriers are disclosed in Davalian, et al., U.S. Pat. No.5,089,390, column 4, line 57 to column 5, line 5, which is incorporatedherein by reference.

As mentioned above, the immunogenic carrier may be a polysaccharide,which is a high molecular weight polymer of monosaccharides that may beprepared naturally or synthetically and usually involves repeatedcondensations of monosaccharides. Examples of polysaccharides arestarches, glycogen, cellulose, carbohydrate gums, such as gum arabic,agar, and so forth. The polysaccharide can also contain poly(amino acid)residues and/or lipid residues.

As mentioned above, in some examples in accordance with the principlesdescribed herein, the immunogenic carrier may be linked to a compound ofthe immunogen that is not the small molecule at a predetermined positionon the compound by means of a linking group. In some examples, thelinking group may comprise about 2 to about 50 atoms, or 4 to about 30atoms, not counting hydrogen and may comprise a chain of from 2 to about30 atoms, or 3 to about 20 atoms, each independently selected from thegroup normally consisting of carbon, oxygen, sulfur, nitrogen, andphosphorous. Part or all of the linking group may be a portion of themolecule being linked to the compound such as, but not limited to, anamino acid residue on a poly(amino acid), for example. In some examples,the linking group comprises an oxime functionality.

The number of heteroatoms in the linking group may be in the range from0 to about 20, or 1 to about 15, or about 2 to about 10. The linkinggroup may be aliphatic or aromatic. When heteroatoms are present, oxygenis normally present as oxo or oxy, bonded to carbon, sulfur, nitrogen orphosphorous, nitrogen is normally present as nitro, nitroso or amino,normally bonded to carbon, oxygen, sulfur or phosphorous; sulfur isanalogous to oxygen; while phosphorous is bonded to carbon, sulfur,oxygen or nitrogen, usually as phosphonate and phosphate mono- ordiester. Common functionalities in forming a covalent bond between thelinking group and the molecule to be conjugated are alkylamine, amidine,thioamide, ether, urea, thiourea, guanidine, azo, thioether andcarboxylate, sulfonate, and phosphate esters, amides and thioesters. Onespecific embodiment of a linking group comprising heteroatoms is anoxime functionality as mentioned above.

For the most part, when a linking group has a linking functionality(functionality for reaction with a moiety) such as, for example, anon-oxocarbonyl group including nitrogen and sulfur analogs, a phosphategroup, an amino group, alkylating agent such as halo or tosylalkyl, oxy(hydroxyl or the sulfur analog, mercapto) oxocarbonyl (e.g., aldehyde orketone), or active olefin such as a vinyl sulfone or α-, β-unsaturatedester, these functionalities are linked to amine groups, carboxylgroups, active olefins, alkylating agents, e.g., bromoacetyl. Where anamine and carboxylic acid or its nitrogen derivative or phosphoric acidis linked, amides, amidines and phosphoramides are formed. Wheremercaptan and activated olefin are linked, thioethers are formed. Wherea mercaptan and an alkylating agent are linked, thioethers are formed.Where aldehyde and an amine are linked under reducing conditions, analkylamine is formed. Where a ketone or aldehyde and a hydroxylamine(including derivatives thereof where a substituent is in place of thehydrogen of the hydroxyl group) are linked, an oxime functionality(═N—O—) is formed. Where a carboxylic acid or phosphate acid and analcohol are linked, esters are formed. Various linking groups are wellknown in the art; see, for example, Cautrecasas, J. Biol. Chem. (1970)245:3059.

Sirolimus as a Specific Example

The following specific description is by way of illustration of, and notas a limitation on, the scope of the present invention. Selection ofimmunosuppressant drugs, and sirolimus in particular, is also by way ofillustration and not limitation as the present invention has generalapplication to detection of any small molecule that has spatiallyseparated regions to which antibodies can be raised against an immunogenthat is not the small molecule and to which such raised antibodies willbind specifically during an assay for the small molecule.

Monoclonal antibodies may be prepared that bind to separate portions ofthe sirolimus molecule (FIG. 1). The separate portions to which themonoclonal antibodies bind may be determined, for example, bycross-reactivity studies using, for example, metabolites of sirolimus,or modified sirolimus.

Referring to FIG. 4, by way of illustration and not limitation, threepotential binding domains on the sirolimus molecule are indicated as D1,D2 and D3. Binding domain D1 extends approximately from ring atom 15 toring atom 21 and includes a triene moiety from ring atom 17 to ring atom22. Binding domain D2 extends approximately from the methyl group onatom 11 to the methoxy group on atom 39. Binding domain D3 extends fromthe methyl group on ring atom 25 to atom 41. In one example inaccordance with the principles described herein, a first antibody isprepared that binds to D1 of the sirolimus molecule. A second antibodyis prepared that binds to sirolimus at a portion of the small moleculeother than a portion to which the first antibody binds, which in thisexample is either domain D2 or domain D3 of the sirolimus molecule. Thesecond antibody is prepared from an immunogen that comprises a haptenthat is not the small molecule or a derivative of the small molecule.The immunogen comprises a hapten that comprises a moiety that isstructurally similar to that of the second portion of the smallmolecule.

The above discussion also applies to the detection of everolimus, thestructure of which is substantially similar to that of sirolimus.

Preparation of Antibodies for Sandwich Assay for Sirolimus

By way of illustration and not limitation, in one approachanti-sirolimus antibody is prepared from an immunogen that comprisessirolimus. The anti-sirolimus antibody binds to domain region D1 ofsirolimus as can be determined by, for example, a screening assay asdescribed hereinbelow.

In one example, by way of illustration and not limitation, a firstmonoclonal antibody is prepared that binds to a portion of sirolimusrepresented by domain region D1. This first monoclonal antibody may beprepared using compound Va (R⁵ is BSA), for example, as an immunogen inthe methods of antibody production described below (see FIGS. 6 and 7).

Referring to FIG. 6, sirolimus (I) is reacted with aminooxyacetic acidto form a mixture of oximes of the Formula IVa (representing formationof an oxime at C-26) and IVb (representing formation of an oxime atC-32). The reaction is carried out in an organic solvent such as, forexample, an alcohol (e.g., methanol or ethanol), under conditions forforming an oxime. In some examples the temperature during the reactionis about 10° C. to about 30° C., or about 15° C. to about 25° C. Thetime period of the reaction is about 1 hour to about 30 hours, or about2 hours to about 24 hours. Compounds IVa and IVb may be separated or themixture of compounds IVa and IVb may be employed in the next step of thepreparation of an immunogen. Separation of IVa and IVb may be carriedout by, but not limited to, chromatography (TLC, HPLC, RPLC, HTLC) andgas chromatography, for example.

FIG. 7 depicts, by way of illustration and not limitation, formation ofan immunogen from compound IVa. A poly(amino)acid immunogenic carrier(R⁵ precursor) is combined with compound of IVa to form a compound ofthe formula Va. The reaction is carried out in an aqueous bufferedmedium at a pH of about 5.0 to about 7.0, or about 5.5 to about 6.5, orabout 6. An activation agent or coupling for facilitating the reactionof the carboxylic acid functionality of Va with an amine group of the R⁵precursor is included in the reaction medium. Such coupling agentsinclude, but are not limited to,1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide (EDAC),N-hydroxysuccinimide (NHS), orN,N,N′,N′-tetramethyl-O-(N-succinimidyl)uronium tetrafluoroborate, orcombinations of two or more of the above. The reaction is carried outunder conditions for forming an amide. In some examples, the reactionmedium is an aqueous medium, which may be solely water or may includefrom 0.1 to about 40 volume percent of a cosolvent, which may be a polarorganic solvent such as for example, an amine (e.g., dimethylformamide(DMF)); an alcohol (e.g., ethanol); or an ether (e.g., furan), forexample. In some examples the temperature during the reaction is about15° C. to about 25° C. The time period of the reaction is about 3 hoursto about 24 hours, or about 4 hours to about 20 hours, or about 4 hoursto about 10 hours, for example. In some examples, by way of illustrationand not limitation, the R⁵ precursor is a protein such as BSA or KLH,for example. An immunogen may also be prepared from compound IVb in asimilar manner to that described above for the preparation of immunogenVa. A mixture of compounds IVa and IVb may also be used to prepare amixture of immunogens.

An anti-tacrolimus antibody is prepared and selected for its binding notonly with tacrolimus but also its cross-reaction with sirolimus. Theanti-tacrolimus antibody binds to a portion of sirolimus other than thatto which the anti-sirolimus antibody binds since domain region D1 ofsirolimus is not present in tacrolimus. The portion of sirolimus towhich the anti-tacrolimus antibody binds is domain region D2, which isstructurally similar to domain region D2′ of tacrolimus. The secondmonoclonal antibody may be prepared using, for example, tacrolimuslinked to an immunogenic carrier as an immunogen for antibodypreparation in methods described above. Examination of the sirolimusstructure by three-dimensional analysis reveals the conformation ofregions D1 and D2.

In a specific example, by way of illustration and not limitation,tacrolimus at the C22 position of the tacrolimus molecule is linked,either directly by a bond or through the intermediacy of a linkinggroup, to an immunogenic carrier. In a particular example, by way ofillustration and not limitation, the keto group at the C22 position isreacted with an amine to produce an oxime. The amine may be, but is notlimited to, carboxymethoxylamine, for example.

In one approach the reaction of tacrolimus with carboxymethoxylamineproduces a carboxymethyl oxime. In this particular example, tacrolimusmay be reacted with carboxymethoxylamine in an alcoholic medium such as,e.g., methanol, ethanol or propanol, in the presence of a buffer saltsuch as, e.g., sodium acetate, to give the carboxymethyl oxime. Thisoxime may be linked to an immunogenic carrier such as, e.g., a highmolecular weight protein, which may be, but is not limited to, bovineserum albumin, thyroglobulin, ovalbumin, fibrinogen, or keyhole limpethemocyanin, for example. In one example, the protein is keyhole limpethemocyanin.

In an example, a method of preparation of the conjugate of tacrolimuswith a high molecular weight protein is as follows: (1) preparation ofthe carboxymethyl oxime of tacrolimus as described above; (2) activatingthe carboxymethyl oxime to produce a reactive N-hydroxysuccinimideester; and (3) reacting the N-hydroxysuccinimide ester with the highmolecular weight protein to produce the conjugate. The activation of thecarboxymethyl oxime to produce the N-hydroxysuccinimide ester isperformed, for example, by using a coupling agent such as awater-soluble carbodiimide such as, for example,3-(3-dimethylaminopropyl 1-ethyl-3-dimethylaminopropyl)-carbodiimidehydrochloride (EDAC).

The monoclonal antibody that binds to both tacrolimus and sirolimus maybe identified, for example, by a screening method, by way ofillustration and not limitation, as follows: The assay is a competitiveassay that utilizes the antibody conjugated to β-galactosidase(antibody-β-galactosidase conjugate) and a sirolimus or tacrolimusanalog coated on the surface of a CrO2 magnetic particle. The assays maybe performed on the Siemens DIMENSION® clinical chemistry system usingsamples containing tacrolimus or sirolimus. The sample is added to areaction vessel. The antibody-β-galactosidase conjugate reagent is addedto the reaction vessel and mixed with the sample. This step allowsformation of a complex comprising tacrolimus or sirolimus with theantibody-β-galactosidase conjugate. Next, tacrolimus or sirolimus analogcoated CrO₂ particle reagent is added to the reaction mixture. Forsirolimus, the analog used to coat the CrO₂ particles is a mixture ofsirolimus-C26 oxime and sirolimus-C32 oxime derivatives as depicted inFIG. 6. For tacrolimus detection, the analog used is FK506-C32-succinate(prepared as described in U.S. Pat. Nos. 5,532,137 and 5,164,495), therelevant disclosure of which is incorporated herein by reference. Afterincubation to allow tacrolimus or sirolimus analog coated CrO₂ particlesto scavenge the excess amount of antibody-β-galactosidase conjugate thatis not bound to tacrolimus or sirolimus, the CrO₂ particles aremagnetically separated from the reaction mixture in the vessel and analiquot of supernatant containing tacrolimus (orsirolimus)::antibody-β-galactosidase conjugate complexes is transferredfrom the reaction vessel to a photometric cuvette containingchlorophenol red-β-D-galactopyranoside (CPRG). The rate of theconversion of CPRG to chlorophenol red (CPR) is measured bichromaticallyat 577 and 700 nm. This rate is proportional to the concentration oftacrolimus or sirolimus in the sample. Antibody is selected fordemonstrating sufficient binding affinity for both tacrolimus andsirolimus based on the concentration of tacrolimus or sirolimus obtainedin the assay.

As can be seen from FIG. 5, domain region D2′ of tacrolimus isstructurally similar to domain region D2 of sirolimus. Tacrolimus may beemployed as a compound linked to an immunogenic carrier to form animmunogen where the compound is not sirolimus or a derivative ofsirolimus but comprises a moiety (domain region D2′ of tacrolimus) thatis structurally similar to that of the domain region D2 of sirolimus.

In the screening assay for obtaining anti-tacrolimus antibody that bindsalso to sirolimus, antibody preparations using an immunogen comprisingtacrolimus are screened in an immunoassay to identify one or moreantibodies that are highly cross-reactive with sirolimus. This approachis contrary to approaches for antibody selection where antibodies arechosen that have little or no cross-reactivity with molecules other thanthe molecule used in the immunogen.

As mentioned above, sirolimus and tacrolimus are used by way of example.The above approach may be applied to other small molecules in order toprepare first and second antibodies to carry out a sandwich assay forthe small molecules. If an assay antibody in a competitive assay formatbinds to a unique epitope or domain of the small molecule where thesmall molecule shares a common domain with, or comprises a domain thatis structurally similar to a domain in, another hapten, such hapten canbe used to generate an antibody that cross-reacts with the smallmolecule analyte. In this manner, two antibodies that bind to separatedomain regions of the small molecule can be prepared and used in asandwich assay for the small molecule.

General Description of Assays for a Small Molecule

As mentioned above, examples in accordance with the principles describedherein enable a sandwich assay for the determination of a small moleculein a sample suspected of containing the small molecule. In thediscussion below, an immunosuppressant drug is used as an example, byway of illustration and not limitation, of a small molecule as definedherein. In the sandwich assay, two monoclonal antibodies are employed,each of which bind at the same time to separate regions of theimmunosuppressant drug molecule to form an immunocomplex. Detection ofthe immunocomplex permits the determination of the immunosuppressantdrug in the sample.

The sample to be tested is usually a biological sample. The phrase“biological sample” refers to any biological material such as, forexample, body fluid, body tissue, body compounds and culture media. Thesample may be a solid, semi-solid or a fluid (a liquid or a gas) fromany source. In some embodiments the sample may be a body excretion, abody aspirant, a body excisant or a body extractant. The body is usuallythat of a mammal and in some embodiments the body is a human body. Bodyexcretions are those substances that are excreted from a body (althoughthey also may be obtained by excision or extraction) such as, forexample, urine, feces, stool, vaginal mucus, semen, tears, breath,sweat, blister fluid and inflammatory exudates. Body excisants are thosematerials that are excised from a body such as, for example, skin, hairand tissue samples including biopsies from organs and other body parts.Body aspirants are those materials that are aspirated from a body suchas, for example, mucus, saliva and sputum. Body extractants are thosematerials that are extracted from a body such as, for example, wholeblood, plasma, serum, spinal fluid, cerebral spinal fluid, lymphaticfluid, synovial fluid and peritoneal fluid. In some examples the sampleis whole blood, plasma or serum.

Prior to the assay, or in some instances during the assay, the samplemay be subjected to one or more pretreatments to lyse cells and/or torelease immunosuppressant drug from endogeneous binding substances.Lysing cells may be accomplished by use of a hemolytic agent, which is acompound or mixture of compounds that disrupts the integrity of themembranes of red blood cells thereby releasing intracellular contents ofthe cells. Hemolytic agents include, but are not limited to, non-ionicdetergents, anionic detergents, amphoteric detergents, low ionicstrength aqueous solutions (hypotonic solutions), bacterial agents, andantibodies that cause complement dependent lysis, for example.

Non-ionic detergents that may be employed as the hemolytic agent includeboth synthetic detergents and natural detergents. Examples of syntheticdetergents include TRITON™ X-100, TRITON™ N-101, TRITON™ X-114, TRITON™X-405, TRITON™ SP-135, TWEEN® 20 (polyoxyethylene (20) sorbitanmonolaurate), TWEEN® 80 (polyoxyethylene (20) sorbitan monooleate),DOWFAX®, ZONYL®, pentaerythrityl palmitate, ADOGEN® 464, ALKANOL® 6112surfactant, allyl alcohol 1,2-butoxylate-block-ethoxylate HLB 6, BRIJ®,ethylenediamine tetrakis(ethoxylate-block-propoxylate) tetrol, IGEPAL®,MERPOL®, poly(ethylene glycol),2-[ethyl[(heptadecafluorooctyl)-sulfonyl]amino] ethyl ether,polyethylene-block-poly(ethylene glycol), polyoxyethylene sorbitantetraoleate, polyoxyethylene sorbitol hexaoleate, TERGITOL® NP-9, GAFAC®(RHODAFAC®, an alkyl polyoxyethylene glycol phosphate ester such as, forexample, alpha-dodecyl-omega-hydroxypoly(oxy-1,2-ethanediyl) phosphate),and EP110® and the like. Naturally-occurring detergents that may beemployed as the hemolytic agent include, for example, saponins, sodiumor potassium neutralized fatty acid, neutralized phospholipids,diacylglycerol, neutralized phosphatidyl serine, phosphatidate,neutralized phosphatidyl ethanoliamin, phosphatidyl choline,phosphatidyl inositol, phosphatidylcholine, bile salt, unesterifiedcholesterol, neutralized sphingosine, ceramide, and the like.Combinations of one or more synthetic detergents or one or morenaturally occurring detergents and combinations of synthetic detergentsand naturally occurring detergents may also be employed.

The nature and amount or concentration of hemolytic agent employeddepends on one or more of the nature of the sample, the nature of theimmunosuppressant drug, the nature of the rest of the reagentcomponents, and the reaction conditions, for example. The amount of thehemolytic agent is at least sufficient to cause lysis of red blood cellsto release contents of the cells. In some examples the amount of thehemolytic agent is about 0.0001% to about 0.5%, about 0.001% to about0.4%, about 0.01% to about 0.3%, about 0.01% to about 0.2%, about 0.1%to about 0.3%, about 0.2% to about 0.5%, or about 0.1% to about 0.2%,for example (percent is weight/volume).

The releasing agent is a compound or mixture of compounds that displacesthe immunosuppressant drug from endogenous binding moieties. Thereleasing agent can, and does in many instances, displace metabolites ofthe immunosuppressant drug from endogenous binding moieties. In manyexamples the releasing agent has high binding affinity to the endogenousbinding proteins so that it readily displaces the immunosuppressantdrug, and its metabolites where desired, from endogenous bindingproteins. In addition, the releasing agent does not bind to anysignificant degree to a monoclonal antibody for the drug that is used inan assay. By the phrase “does not bind to any significant degree” ismeant that the extent of binding should be low enough so that anaccurate assay for the drug may be carried out. The releasing agent,therefore, may be any moiety, either a single compound or a mixture ofcompounds, which accomplishes the desired result of displacement with nosignificant binding to an assay antibody.

In some examples the releasing agent is an analog, including structuralanalogs, of the immunosuppressant drug. An immunosuppressant drug analogis a modified drug that can displace the analogous immunosuppressantdrug from a binding protein but does not compete to any substantialdegree for a monoclonal antibody for the immunosuppressant drug. Themodification provides means to join an immunosuppressant drug analog toanother molecule. In an example, the immunosuppressant drug analog maybe, for example, the immunosuppressant drug conjugated to anothermolecule through a linking group. For immunosuppressant drugs thatcomprise a hydroxy or carboxylic acid functionality, the releasing agentmay be an ester of the immunosuppressant drug, which has a high bindingaffinity for endogenous binding proteins relative to theimmunosuppressant drug to be detected and which has no significantbinding affinity for an antibody for the immunosuppressant drug. Forexample, in a determination for tacrolimus, an ester of tacrolimus maybe employed as the releasing agent so long as it meets the aboverequirements. A structural analog is a moiety that has the same orsimilar structural or spatial characteristics as the immunosuppressantdrug such that the structural analog accomplishes the same or similarresult as the analog of the immunosuppressant drug. The structuralanalog may be, for example, another compound that is related to theimmunosuppressant drug. For example, in a determination for tacrolimus,an ester of sirolimus may be employed as the releasing agent. The estermay be, for example, a carbamate, a carbonate, an ester of a C₁ to C₆carboxylic acid, and the like. See, for example, U.S. Pat. No.7,186,518, the relevant disclosure of which is incorporated herein byreference. Other examples of releasing agents include [Thr₂, Leu₅,D-Hiv₈, Leu₁₀]-cyclosporin A for cyclosporin A, FK506 for sirolimus,sirolimus for FK506, and the like. See, for example, U.S. Pat. No.6,187,547, the relevant disclosure of which is incorporated herein byreference.

The concentration of the releasing agent in the medium is thatsufficient to achieve the desired result of displacing theimmunosuppressant drug, and in some instances the metabolites of theimmunosuppressant drug, from endogenous binding moieties to render thedrug and metabolites accessible for binding to an antibody for the drugas discussed above. The amount or concentration of the releasing agentemployed depends on one or more of the nature of the sample, the natureof the immunosuppressant drug, the nature of the drug metabolites, thenature of other reagent components, and the reaction conditions, forexample. In some embodiments the amount of the releasing agent is about0.000001% to about 0.5%, about 0.0001% to about 0.4%, about 0.001% toabout 0.3%, about 0.01% to about 0.2%, about 0.1% to about 0.3%, about0.2% to about 0.5%, about 0.1% to about 0.2%, and so forth (percent isweight/volume).

The assay is an immunoassay, which may be performed either withoutseparation (homogeneous) or with separation (heterogeneous) of any ofthe assay components or products. The homogeneous or heterogeneousassays are carried out in an aqueous buffered medium at a moderate pH,generally that which provides optimum assay sensitivity. The aqueousmedium may be solely water or may include from 0.1 to about 40 volumepercent of a cosolvent. The pH for the medium will usually be in therange of about 4 to about 11, or in the range of about 5 to about 10, orin the range of about 6.5 to about 9.5. The pH will usually be acompromise between optimum binding of the monoclonal antibodies and theimmunosuppressant drug, and the pH optimum for other reagents of theassay such as members of the signal producing system, for example.

Various buffers may be used to achieve the desired pH and maintain thepH during the determination. Illustrative buffers include borate,phosphate, carbonate, tris, barbital and the like. The particular bufferemployed is not critical to this invention, but in an individual assayone or another buffer may be preferred. Various ancillary materials maybe employed in the above methods. For example, in addition to buffersthe medium may comprise stabilizers for the medium and for the reagentsemployed. Frequently, in addition to these additives, proteins may beincluded, such as albumins; organic solvents such as formamide;quaternary ammonium salts; polyanions such as dextran sulfate;surfactants, particularly non-ionic surfactants; binding enhancers,e.g., polyalkylene glycols; for example.

One or more incubation periods may be applied to the medium at one ormore intervals including any intervals between additions of variousreagents mentioned above. The medium is usually incubated at atemperature and for a time sufficient for binding of various componentsof the reagents to occur. Moderate temperatures are normally employedfor carrying out the method and usually constant temperature,preferably, room temperature, during the period of the measurement.Incubation temperatures range from about 5° to about 99° C., or about15° C. to about 70° C., or about 20° C. to about 45° C. The time periodfor the incubation is about 0.2 seconds to about 6 hours, or about 2seconds to about 1 hour, or about 1 to about 5 minutes. The time perioddepends on the temperature of the medium and the rate of binding of thevarious reagents, which is determined by the association rate constant,the concentration, the binding constant and dissociation rate constant.Temperatures during measurements range from about 10° C. to about 50°C., or from about 15° C. to about 40° C.

The concentration of immunosuppressant drug analyte that may be assayedgenerally varies from about 10⁻⁵ to about 10⁻¹⁷ M, or from about 10⁻⁶ toabout 10⁻¹⁴ M. Considerations, such as whether the assay is qualitative,semi-quantitative or quantitative (relative to the amount of analytepresent in the sample), the particular detection technique and theconcentration of the analyte normally determine the concentrations ofthe various reagents.

The concentrations of the various reagents in the assay medium willgenerally be determined by the concentration range of interest of theimmunosuppressant drug analyte. However, the final concentration of eachof the reagents is normally determined empirically to optimize thesensitivity of the assay over the range. That is, a variation inconcentration of analyte that is of significance should provide anaccurately measurable signal difference. Considerations such as thenature of a signal producing system and the nature of theimmunosuppressant analyte normally determine the concentrations of thevarious reagents.

While the order of addition may be varied widely, there will be certainpreferences depending on the nature of the assay. The simplest order ofaddition is to add all the materials simultaneously and determine theeffect that the assay medium has on the signal as in a homogeneousassay. Alternatively, the reagents can be combined sequentially.Optionally, an incubation step may be involved subsequent to eachaddition as discussed above.

In the assays discussed above, one or more labels are employed whereinthe label is usually part of a signal producing system (“sps”). Thenature of the label is dependent on the particular assay format. An spsusually includes one or more components, at least one component being adetectable label, which generates a detectable signal that relates tothe amount of bound and/or unbound label, i.e. the amount of label boundor not bound to the immunosuppressant drug being detected or to an agentthat reflects the amount of the immunosuppressant drug to be detected.The label is any molecule that produces or can be induced to produce asignal, and may be, for example, a fluorescer, a radiolabel, an enzyme,a chemiluminescer or a photosensitizer. Thus, the signal is detectedand/or measured by detecting enzyme activity, luminescence, lightabsorbance or radioactivity, as the case may be.

Suitable labels include, by way of illustration and not limitation,enzymes such as β-galactosidase, alkaline phosphatase,glucose-6-phosphate dehydrogenase (“G6PDH”) and horseradish peroxidase;ribozyme; a substrate for a replicase such as QB replicase; promoters;dyes; fluorescers, such as fluorescein, isothiocyanate, rhodaminecompounds, phycoerythrin, phycocyanin, allophycocyanin, o-phthaldehyde,and fluorescamine; complexes such as those prepared from CdSe and ZnSpresent in semiconductor nanocrystals known as Quantum dots;chemiluminescers such as isoluminol; sensitizers; coenzymes; enzymesubstrates; radiolabels such as ¹²⁵I, ¹³¹I, ¹⁴C, ³H, ⁵⁷CO and ⁷⁵Se;particles such as latex particles, carbon particles, metal particlesincluding magnetic particles, e.g., chrome particles, and the like;metal sol; crystallite; liposomes; cells, etc., which may be furtherlabeled with a dye, catalyst or other detectable group. Suitable enzymesand coenzymes are disclosed in Litman, et al., U.S. Pat. No. 4,275,149,columns 19-28, and Boguslaski, et al., U.S. Pat. No. 4,318,980, columns10-14; suitable fluorescers and chemiluminescers are disclosed inLitman, et al., U.S. Pat. No. 4,275,149, at columns 30 and 31; which areincorporated herein by reference.

The label can directly produce a signal and, therefore, additionalcomponents are not required to produce a signal. Numerous organicmolecules, for example fluorescers, are able to absorb ultraviolet andvisible light, where the light absorption transfers energy to thesemolecules and elevates them to an excited energy state. This absorbedenergy is then dissipated by emission of light at a second wavelength.Other labels that directly produce a signal include radioactive isotopesand dyes.

Alternately, the label may need other components to produce a signal,and the signal producing system would then include all the componentsrequired to produce a measurable signal. Such other components mayinclude substrates, coenzymes, enhancers, additional enzymes, substancesthat react with enzymic products, catalysts, activators, cofactors,inhibitors, scavengers, metal ions, and a specific binding substancerequired for binding of signal generating substances. A detaileddiscussion of suitable signal producing systems can be found in Ullman,et al., U.S. Pat. No. 5,185,243, columns 11-13, incorporated herein byreference.

The label or other sps members or one or more of the monoclonalantibodies can be bound to a support. A monoclonal antibody may be boundto a solid support in any manner known in the art, provided only thatthe binding does not substantially interfere with the ability to bindwith a region of the immunosuppressant drug. In some examples, the labelor other sps member or the monoclonal antibody may be coated orcovalently bound directly to the solid phase or may have layers of oneor more carrier molecules such as poly(amino acids) including proteinssuch as serum albumins or immunoglobulins, or polysaccharides(carbohydrates) such as, for example, dextran or dextran derivatives.Linking groups may also be used to covalently couple the solid supportand the moiety to be coupled. The linking group may be one as describedabove for the linking of immunogen to an immunosuppressant drugmolecule. Other methods of binding to a support may also be employed.For instance, a solid support may have a coating of a binder for a smallmolecule such as, for example, avidin or an antibody, where a smallmolecule such as, e.g., biotin or a hapten, can be bound to the moietyto be coupled or vice versa. The binding of components to the surface ofa support may be direct or indirect, covalent or non-covalent and can beaccomplished by well-known techniques, commonly available in theliterature. See, for example, “Immobilized Enzymes,” Ichiro Chibata,Halsted Press, New York (1978) and Cautrecasas, J. Biol. Chem., 245:3059(1970).

The support may be comprised of an organic or inorganic, solid or fluid,water insoluble material, which may be transparent or partiallytransparent. The support can have any of a number of shapes, such asparticle, including bead, film, membrane, tube, well, strip, rod, planarsurfaces such as, e.g., plate, and DENDRIMERS, for example. Depending onthe type of assay, the support may or may not be suspendable in themedium in which it is employed. Examples, by way of illustration and notlimitation, of suspendable supports are polymeric materials such aslatex, lipid bilayers or liposomes, oil droplets, cells and hydrogels,and magnetic particles, for example. Other support compositions includepolymers, such as nitrocellulose, cellulose acetate, poly (vinylchloride), polyacrylamide, polyacrylate, polyethylene, polypropylene,poly(4-methylbutene), polystyrene, polymethacrylate, poly(ethyleneterephthalate), nylon, poly(vinyl butyrate), for example; either used bythemselves or in conjunction with other materials.

The support may be a particle. The particles should have an averagediameter of at least about 0.02 microns and not more than about 100microns. In some embodiments, the particles have an average diameterfrom about 0.05 microns to about 20 microns, or from about 0.3 micronsto about 10 microns. The particle may be organic or inorganic, swellableor non-swellable, porous or non-porous, preferably of a densityapproximating water, generally from about 0.7 g/mL to about 1.5 g/mL,and composed of material that can be transparent, partially transparent,or opaque. The particles can be biological materials such as cells andmicroorganisms, e.g., erythrocytes, leukocytes, lymphocytes, hybridomas,streptococcus, Staphylococcus aureus, and E. coli, viruses, for example.The particles can also be particles comprised of organic and inorganicpolymers, liposomes, latex particles, magnetic or non-magneticparticles, phospholipid vesicles, chylomicrons, lipoproteins, and thelike. In some examples, the particles are chrome particles or latexparticles.

The polymer particles can be formed of addition or condensationpolymers. The particles will be readily dispersible in an aqueous mediumand can be adsorptive or functionalizable so as to permit conjugation toa monoclonal antibody for an immunosuppressant drug, either directly orindirectly through a linking group. The linking group may be one asdescribed above for the linking of immunogens to an immunosuppressantdrug molecule. The particles can also be derived from naturallyoccurring materials, naturally occurring materials that aresynthetically modified, and synthetic materials. Among organic polymersof particular interest are polysaccharides, particularly cross-linkedpolysaccharides, such a agarose, which is available as Sepharose,dextran, available as Sephadex and Sephacryl, cellulose, starch, and thelike; addition polymers, such as polystyrene, polyvinyl alcohol,homopolymers and copolymers of derivatives of acrylate and methacrylate,particularly esters and amides having free hydroxyl functionalities, andthe like.

The label and/or other sps member may be bound to one or both of the twodifferent monoclonal antibodies. Bonding of the label to the sbp membermay be accomplished by chemical reactions that result in replacing ahydrogen atom of the label with a bond to the monoclonal antibody or mayinclude a linking group between the label and the monoclonal antibody.The linking group may be one as described above for the linking ofimmunogens to an immunosuppressant drug molecule. Other sps members mayalso be bound covalently to the monoclonal antibodies. For example, twosps members such as a fluorescer and quencher can each be bound,respectively, to the monoclonal antibodies where the fluorescer is boundto one of the monoclonal antibodies and a quencher is bound to the otherof the monoclonal antibodies. When the two different monoclonalantibodies bind to the immunosuppressasnt drug, the formation of asandwich complex brings the fluorescer and quencher in close proximity,thus permitting the quencher to interact with the fluorescer to producea signal. Methods of conjugation are well known in the art. See, forexample, Rubenstein, et al., U.S. Pat. No. 3,817,837, incorporatedherein by reference.

Enzymes of particular interest as label proteins are redox enzymes,particularly dehydrogenases such as glucose-6-phosphate dehydrogenase,lactate dehydrogenase, etc., and enzymes that involve the production ofhydrogen peroxide and the use of the hydrogen peroxide to oxidize a dyeprecursor to a dye. Particular combinations include, but are not limitedto, saccharide oxidases, e.g., glucose and galactose oxidase, orheterocyclic oxidases, such as uricase and xanthine oxidase, coupledwith an enzyme which employs the hydrogen peroxide to oxidize a dyeprecursor, that is, a peroxidase such as horse radish peroxidase,lactoperoxidase, or microperoxidase. Additional enzyme combinations areknown in the art. When a single enzyme is used as a label, other enzymesmay find use such as hydrolases, transferases, and oxidoreductases,preferably hydrolases such as alkaline phosphatase andbeta-galactosidase. Alternatively, luciferases may be used such asfirefly luciferase and bacterial luciferase.

Illustrative co-enzymes that find use include NAD[H], NADP[H], pyridoxalphosphate, FAD[H], FMN[H], etc., usually coenzymes involving cyclingreactions. See, for example, U.S. Pat. No. 4,318,980, the disclosure ofwhich is incorporated herein by reference.

Activation of a signal producing system depends on the nature of thesignal producing system members. For those members of a signal producingsystem that are activated with light, the member is irradiated withlight. For members of signal producing systems that are on the surfaceof a particle, addition of a base may result in activation. Otheractivation methods will be suggested to those skilled in the art in viewof the disclosures herein. For some signal producing systems, no agentfor activation is necessary such as those systems that involve a labelthat is a radioactive label, an enzyme, and so forth. For enzyme systemsaddition of a substrate and/or a cofactor may be necessary.

The examination for presence and amount of the signal also includes thedetection of the signal, which is generally merely a step in which thesignal is read. The signal is normally read using an instrument, thenature of which depends on the nature of the signal. The instrument maybe a spectrophotometer, fluorometer, absorption spectrometer,luminometer, chemiluminometer, actinometer, photographic instrument, andthe like. The presence and amount of signal detected is related to thepresence and amount of the sirolimus compound present in a sample.Temperatures during measurements may range from about 10° to about 70°C., or from about 20° to about 45° C., or from about 20° to about 25° C.In one approach standard curves are formed using known concentrations ofthe analytes to be screened. As discussed above, calibrators and othercontrols may also be used.

The phrase “measuring the amount of an immunosuppressant drug” refers tothe quantitative, semi-quantitative and qualitative determination of theimmunosuppressant drug. Methods that are quantitative, semi-quantitativeand qualitative, as well as all other methods for determining theimmunosuppressant drug, are considered to be methods of measuring theamount of the immunosuppressant drug. For example, a method, whichmerely detects the presence or absence of the immunosuppressant drug ina sample suspected of containing the immunosuppressant drug, isconsidered to be included within the scope of the present disclosure.The terms “detecting” and “determining,” as well as other commonsynonyms for measuring, are contemplated within the scope of the presentdisclosure.

In one example in accordance with the principles described herein, oneof the monoclonal antibodies specific for a region of animmunosuppressant drug is bound to a support and the other of themonoclonal antibodies that is specific for a region of theimmunosuppressant drug that is spatially separated from the region ofthe immunosuppressant drug to which the other monoclonal antibodiesbinds is bound to an sps member such as, for example, a label. Thesample suspected of containing the immunosuppressant drug is combined ina suitable medium with the two conjugated monoclonal antibodies and themedium is incubated. Then, the medium is examined for the one or both ofthe presence and amount of an immunocomplex formed by the two differentmonoclonal antibodies and the immunosuppressant drug from the sample.The support may or may not be separated from the medium prior to theexamination. The presence and/or amount of the immunocomplex isdetermined by determining the presence and/or amount of the label in themedium or on the support.

In one particular example, a capture assay is employed. In this assayformat, one monoclonal antibody is covalently bound to a magneticparticle such as, for example, a chrome (chromium dioxide) particle. Thesample is incubated with these particles to allow the immunosuppressantdrug in the sample to bind to the monoclonal antibody on the magneticparticle. Subsequently, a second monoclonal antibody conjugated to anenzyme such as, for example, β-galactosidase, is incubated with themagnetic particles. After application of a magnet and washing of themagnetic particles, the amount of enzyme that is bound to the magneticparticles is measured and is directly related to the presence and/oramount of the immunosuppressant drug in the sample. In this approachsubstrate of the reporter enzyme is added to the final reactioncontainer, and the enzyme activity is measured spectrophotometrically asa change in absorbance over time.

In an alternative approach, the magnetic particle reagent is added in anexcess amount, i.e., an amount greater than that required to bind all ofthe immunosuppressant drug that might be present in the sample. Then, amagnet is applied to separate the magnetic particles from the medium andthe magnetic particles are washed and resuspended in assay medium. Theenzyme conjugated to the second monoclonal antibody is added and themedium is incubated followed by signal determination as described above.

In another example, by way of illustration and not limitation,chemiluminescent particles are employed, which comprise thechemiluminescent compound associated therewith such as by incorporationtherein or attachment thereto. One of the monoclonal antibodies for theimmunosuppressant drug is bound to the particles such as through theintermediacy of a polysaccharide coating the particles. The othermonoclonal antibody that binds to the immunosuppressant drug is part ofa biotin conjugate. Streptavidin is conjugated to a second set ofparticles having a photosensitizer associated therewith. Thechemiluminescent particles are mixed with a sample suspected ofcontaining the immunosuppressant drug and the photosensitizer particles.The reaction medium is incubated to allow the particles to bind to theimmunosuppressant drug by virtue of the binding of the monoclonalantibodies to the immunosuppressant drug. Then, the medium is irradiatedwith light to excite the photosensitizer, which is capable in itsexcited state of activating oxygen to a singlet state. Because thechemiluminescent compound of one of the sets of particles is now inclose proximity to the photosensitizer by virtue of the presence of theimmunosuppressant drug, it is activated by singlet oxygen and emitsluminescence. The medium is then examined for the presence and/or theamount of luminescence or light emitted, the presence thereof beingrelated to the presence and/or amount of the immunosuppressant drug in asample.

Kits for Conducting Assays

The reagents for conducting a particular assay may be present in a kituseful for conveniently performing an assay for the determination of asmall molecule such as, for example, an immunosuppressant drug analyte.In one example, a kit comprises in packaged combination reagents foranalyzing for the analyte, the nature of which depend upon theparticular assay format. The reagents may include, for example, one ormore monoclonal antibodies in accordance with the principles describedherein, which may be conjugated to a label or a support. The reagentsmay each be in separate containers or various reagents can be combinedin one or more containers depending on the cross-reactivity andstability of the reagents. The kit can further include other separatelypackaged reagents for conducting an assay such as additional bindingmembers and ancillary reagents.

The relative amounts of the various reagents in the kits can be variedwidely to provide for concentrations of the reagents that substantiallyoptimize the reactions that need to occur during the present method andfurther to optimize substantially the sensitivity of the assay. Underappropriate circumstances one or more of the reagents in the kit can beprovided as a dry powder, usually lyophilized, including excipients,which on dissolution will provide for a reagent solution having theappropriate concentrations for performing a method or assay. The kit canfurther include a written description of a method in accordance with thepresent embodiments as described above.

The phrase “at least” as used herein means that the number of specifieditems may be equal to or greater than the number recited. The phrase“about” as used herein means that the number recited may differ by plusor minus 10%; for example, “about 5” means a range of 4.5 to 5.5. Thedesignation “first” and “second” is completely arbitrary and is notmeant to suggest any order or ranking among any members of a group towhich the above language pertains such as, for example, “first andsecond monoclonal antibodies” or “first monoclonal antibody” and “secondmonoclonal antibody.”

The following examples further describe the specific embodiments of theinvention by way of illustration and not limitation and are intended todescribe and not to limit the scope of the invention or the claimsattached hereto. Parts and percentages disclosed herein are by volumeunless otherwise indicated.

EXAMPLES

All chemicals were purchased from the Sigma-Aldrich Company (St. LouisMo.) unless otherwise noted.

Testing was carried out using the DIMENSION® RxL analyzer, availablefrom Siemens AG, Newark Del. The instrument was employed using enzymaticdetection system with sandwich immunoassay format. In the embodiment ofthe sandwich method used herein and discussed in more detail below,binding between a labeled antibody (Ab) conjugated to an enzyme(conjugate) and sirolimus drug (SIRO) in patient samples and subsequentbinding of the resulting immunocomplex with a capture antibody on chromeparticles determined the amount of sirolimus in the patient samples. Theunbound tag antibody enzyme conjugate was removed automatically by 3-4mix/wash and magnetic separation cycles. The enzymatic activity fromconjugate remaining on the chrome particles was measured and wasdirectly proportional to the amount of sirolimus in the patient sample.

Definitions:

-   -   mg=milligram    -   g=gram(s)    -   ng=nanogram(s)    -   mL=milliliter(s)    -   μL=microliter(s)    -   mmol(s)=millimole(s)    -   μmol=micromolar    -   ° C.=degrees Centigrade    -   min=minute(s)    -   sec=second(s)    -   hr=hour(s)    -   w/v=weight to volume    -   v/v=volume to volume    -   TLC=thin layer chromatography    -   HPLC=high performance liquid chromatography    -   UV=ultraviolet    -   EtOAc=ethyl acetate    -   MeOH=methanol    -   DMF=dimethylformamide    -   DI=deionized    -   THF=tetrahydrofuran    -   NHS=N-hydroxysuccinimide    -   DCC=N,N-dicyclohexyl carbodiimide    -   BSA=bovine serum albumin    -   BGG=bovine gamma globulin    -   MS=mass spectrometry    -   SIRO=sirolimus    -   rotovap=rotary evaporator

Example 1 Preparation of Monoclonal Antibody to Sirolimus

Preparation of C-32-Sirolimus and C-26-Sirolimus Oximes (IVa and IVb)(FIG. 6). To a solution of Sirolimus (I) (653.6 mg, 0.715 mmol) andcarboxymethoxyamine hemihydrochloride (234.4 mg, 2.14 mmol) in MeOH (20mL) is added sodium acetate (181.8 mg, 3.1 mmol). The reaction mixtureis stirred at room temperature (23° C.) overnight (18 hr) under anitrogen atmosphere. TLC analysis indicated that the reaction iscompleted. (TLC, Silica gel plate, CH₂Cl₂/MeOH=9/1). CH₂Cl₂ (80 mL) andDI water (20 mL) is added to the mixture, which is stirred 10 min. TheCH₂Cl₂layer is separated. The aqueous layer is extracted with CH₂Cl₂(3×30 mL). The combined CH₂Cl₂ solutions are washed with DI water (2×40mL), are dried over Na2SO4, are filtered and are concentrated on arotovap to give a mixture of C-32-Sirolimus and C-26-Sirolimus oximes(IVa and IVb, 622 mg).

Isolation of C-26-Sirolimus Oxime (IVa) (FIG. 6). An optimal TLCcondition (silica gel, EtOAc/Hexanes/MeOH=5/2/1, R_(f) C-32-oxime=0.59,R_(f) C-26-oxime=0.51) for the separation of C-32-Sirolimus andC-26-Sirolimus oximes is developed and applied successfully in anBIOTAGE® ISOLERA™ One Flash Chromatography System (John MorrisScientific, Chatswood, NSW). A mixture of C-32-Sirolimus andC-26-Sirolimus oximes (IVa and IVb, 622 mg) is dissolved in CH₂Cl₂ (5mL). The CH₂Cl₂ solution is eluted to a cartridge (silica, 50 g SNAPUltra) associated with the BIOTAGE® ISOLERA™ One Flash ChromatographySystem. The system is run with mixed solvent in a flow rate of 25mL/min. All the collected fractions from the cartridge are checked byTLC (EtOAc/Hexanes/MeOH=5/2/1). Base on TLC analysis, the more polarpure fractions (R_(f) C-26-oxime=0.51) are combined and concentrated togive C-26-Sirolimus oximes (IVa) (197 mg). HPLC-UV analysis of thiscompound indicates a purity of 95%.

Preparation of C-26-Sirolimus Oxime-BSA Conjugate (Va) (R⁵=BSA in FIG.7). To a solution of IVa (167.97 mg, 0.17 mmol) in THF/DMF (8 mL THF,0.4 mL DMF), NHS (41.8 mg, 0.35 mmol) and DCC (70.9 mg, 0.34 mmol) isadded. The reaction mixture is stirred at room temperature under anitrogen atmosphere and the product NHS ester is slightly less polarthan compound IVa in TLC analysis. A white solid formed during thereaction is filtered and then washed with EtOAc. After solvent isremoved, the reaction mixture iredissolved in EtOAc and filtered;evaporation of solvent afforded a slight yellow solid, which is heldunder high vacuum for 1 hr.

The activated hapten NHS ester (slight yellow solid) is dissolved in DMF(1 mL) and the solution is added dropwise to a BSA (120 mg) in phosphatebuffered saline (PBS) buffer (0.1 M NaH₂PO₄/Na₂HPO₄, pH 8) (14 mL) in anice bath. After stirring for 1 hr at room temperature, pH of thesolution is adjusted to pH 8 with NaOH (1N) and the mixture is stirredin a cold room (4° C.) overnight. The BSA conjugate is purified throughan equilibrated SEPHADEX® G-25 column (C26×70) with PBS buffer (0.1 MNaH₂PO₄/Na₂PO₄, pH 7), and eluted with same PBS buffer. A UV detector at280 nm is used to monitor the eluted fractions from the column. A cleanseparation between BSA conjugate and the unconjugated hapten IVa isobserved. Fractions containing BSA conjugate (Va) are pooled to a totalof 57 mL, and the concentration of the Va is determined to be 2.52 mg/mLby the BCA Protein Concentration Assay (Pierce Biotechnology, RockfordIll.).

Preparation of Monoclonal Antibody that Binds to Domain D1 of Sirolimus.Monoclonal antibodies that bind to domain D1 of the sirolimus moleculeare prepared as follows. The immunogen is the BSA conjugate Va preparedas described above. This immunogen is used to immunize Balb/c mice. Thefirst immunization is 25 μg in a volume of 200 μl with monophosphoryllipid A and synthetic trehalose dicorynomycolate adjuvant (RIBI MPL+TDMEmulsion, RIBI ImmunoChem Research Inc., Hamilton Mont.)intraperitoneally. Five weeks later a boost immunization is given with25 μg of the immunogen in 200 μl of monophosphoryl lipid A and synthetictrehalose dicorynomycolate adjuvant intraperitoneally. Subsequently,after another 8 weeks, a prefusion boost is given of the 25 μg of theimmunogen in 200 μl of Hanks' Balanced Salt Solution intravenously andintraperitoneally.

Three days later, fusion is performed by standard methods using anonsecreting murine myeloma designated P3×63-AG8.653. Cloning is carriedout by standard methods.

The clones are screened by the following reverse ELISA immunoassayprocedure according to the following protocol. Plates are coated withpolyclonal goat anti-mouse IgG (IgG+IgA+IgM) (Zymed Laboratories, SouthSan Francisco Calif.) at 5 μg/ml in phosphate buffered saline at 100 μlper well. Plate coating is performed for 2 hours or more at roomtemperature or overnight at about 4° C. The plates are then flicked dryand blocked with 300 μl per well of blocking buffer diluent (0.5% bovineserum albumin, 0.05% TWEEN® 20 in PBS). Plate blocking is performed byincubation for 15 minutes or more at room temperature with plateshaking. The plates are then flicked dry. The monoclonal antibody to bescreened is then added to each well as follows: 50 μl per well ofblocking buffer diluent was added along with 50 μl per well culturesupernatant transferred from the corresponding well in the fusion growthplate. Incubation is for about 1 hour at room temperature with shaking.The plate is washed using a TITERTECK PLUS® plate washer with S20stacker with the washing buffer being PBS with 0.05% TWEEN® 20. Anenzyme conjugate of sirolimus covalently coupled to glucose-6-phosphatedehydrogenase diluted in blocking buffer diluent to 1:4000 is added at100 μl per well. Incubation is performed for about 1 hour at roomtemperature with shaking. The plate is then washed and a chromogenicsolution is added at a volume of 100 μl per well. The chromogenicsolution contains 0.593 mM p-iodonitrotetrazolium violet, 0.02 M NAD,0.033 M glucose-6-phosphate, 0.055 M Tris, 0.02% sodium azide, and a1:4000 dilution of diaphorase (lipoyl dehydrogenase). BSA is present at1% (vol/vol) of a 5% w/vol BSA solution. BSA is used to help preventrapid precipitation of reduced p-iodonitrotetrazolium violet.

From the screening a hybridoma producing a suitable monoclonal antibodythat binds to domain D1 of sirolimus is selected.

Preparation of hemolytic pretreatment solution. This pretreatmentsolution contains 5 μg/mL of FK506, 6.8 mg/mL PIPES™ 1.5 sodium salt,0.3 mg/mL EDTA Disodium, 1.0 mg/mL Saponin, 0.2% PROCLIN® 300, 0.024mg/mL Neomycin sulfate and 0.99 mg/mL NaN3, pH 6.5. The FK506concentration in the final reaction mixture is 1.1 μg/mL.

Preparation of Monoclonal Antibody that Binds to Tacrolimus andSirolimus

Preparation of Tacrolimus-Keyhole Limpet Hemocyanin Conjugates. To asolution of tacrolimus monooxime (32.3 mg, 36.8 μmol) in 1.05 mL ofanhydrous dimethylformamide is added1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride (EDAC) (11mg, 57.4 μM, 1.5 equiv.) and N-hydroxysuccinimide (7.3 mg, 63.4 μM, 1.7equiv.). Linkage is at the C22 position of the tacrolimus molecule. Thereaction is stirred at room temperature for 1 hour under argon. Themixture is then added dropwise via a syringe to a solution of keyholelimpet hemocyanin (74 mg, 54% pure) in 5.0 mL of phosphate bufferedsaline (0.1 M, pH 8.0) and 0.25 mL of dimethylformamide. After stirringat room temperature for 2 hours, the resulting suspension is dialyzed(1×4 L, 4° C., 2 hours) against PBS (phosphate buffered saline) (10 mM,pH 7.0).

The resulting mixture is then extracted 3 times with methylene chlorideto remove any trace amount of unreacted tacrolimus monooximes.Quantitative analysis of the mixture is conducted using bicinchoninicacid (BCA) protein assay solution to give 50 mg of immunogen in 8 ml ofPBS (10 mM, pH 7.0).

Determination of the hapten number using the TNBS method (A.F.S.A.Habeeb, Anal. Biochem. 14:328 (1966)) gives a hapten number of 1300. Theimmunogen is immediately frozen using a dry ice-acetone bath and kept at−20° C. for storage.

An immunogen mixture containing three positional isomers of tacrolimus(KLH linked at position C32, KLH linked at position C24 and KLH linkedat positions C32 and C24) is prepared as follows: Tacrolimus (301.3 mg)in a round bottomed flask is dried in vacuum for 1.5 hours. To the flaskis added a stirrer bar, succinic anhydride (568.2 mg),4-(dimethylamino)pyridine (46.3 mg), dichloromethane (2 mL, anhydrous)and pyridine (2.093 mL). The reaction mixture is stirred at roomtemperature (24° C.) under nitrogen atmosphere for 24.5 hours. Threepositional isomers are the products of this reaction:tacrolimus-32-succinate, tacrolimus-24-succinate and tacrolimus-24,32-di-succinate. Once reaction is stopped, solvent is removed by rotaryevaporation and the product is dried further by vacuum pump for twohours.

To a vial is added the tacrolimus-succinate mixture from above (2.5 mg,2.8 μmoles), N-hydroxysuccinimide (1.0 mg, 8.7 μmoles) and anhydrousacetonitrile (250 μL). The mixture is capped and stirred at roomtemperature. To the stirring mixture is addedN,N-dicyclohexylcarbodiimide (3.0 mg, 15 μmoles). The vial is capped andthe mixture was stirred at room temperature.

After 2 hours, the mixture is evaporated to dryness. The resultingmaterial is dissolved in anhydrous N,N-dimethylformamide (250 μL). Thisis the working solution of activated FK506-succinate.

In a 20 mL vial is added a solution of KLH (8 mg) in 8 mL of 10 mMphosphate buffer pH 8, and DMF (1.5 mL). The mixture is chilled to about4° C. and 200 μL of the working solution from above is added dropwisewith stirring to the chilled solution. The mixture is stirred for 16-24hours at 4° C. and then is diluted to 30 mL with water, desalted withtwo CENTRICON® 30 filters, and reconstituted with fresh water 3 moretimes. The final material is diluted to 10 mL with water. Proteinconcentration is determined by BCA protein assay method.

Preparation of Monoclonal Antibody to Tacrolimus and Sirolimus.Monoclonal antibody that binds to both tacrolimus and sirolimus areprepared as follows. The immunogen is tacrolimus-keyhole limpethemocyanin conjugate prepared as described above. This immunogen is usedto immunize Balb/c mice. The first immunization is 25 μg in a volume of200 μl with monophosphoryl lipid A and synthetic trehalosedicorynomycolate adjuvant (RIBI MPL+TDM Emulsion, RIBI ImmunoChemResearch Inc., Hamilton Mont.) intraperitoneally. Five weeks later aboost immunization is given with 25 μg of the immunogen in 200 μl ofmonophosphoryl lipid A and synthetic trehalose dicorynomycolate adjuvantintraperitoneally. Subsequently, after another 8 weeks, a prefusionboost is given of the 25 μg of the immunogen in 200 μl of Hanks'Balanced Salt Solution intravenously and intraperitoneally.

Three days later, fusion is performed by standard methods using anon-secreting murine myeloma designated P3×63-AG8.653. Cloning iscarried out by standard methods.

The clones were screened by the following reverse ELISA immunoassayprocedure according to the following protocol. Plates are coated withpolyclonal goat anti-mouse IgG (IgG+IgA+IgM) (Zymed Laboratories, SouthSan Francisco Calif.) at 5 μg/ml in phosphate buffered saline at 100 μlper well. Plate coating is performed for 2 hours or more at roomtemperature or overnight at about 4° C.; the plates could be storedwrapped in film at about 4° C. for several days. The plates are thenflicked dry and blocked with 300 μl per well of blocking buffer diluent(0.5% bovine serum albumin, 0.05% Tween® 20 in PBS). Plate blocking isperformed by incubation for 15 minutes or more at room temperature withplate shaking. The plates are then flicked dry. The monoclonal antibodyto be screened is then added to each well as follows: 50 μl per well ofblocking buffer diluent is added along with 50 μl per well culturesupernatant transferred from the corresponding well in the fusion growthplate. Incubation is for about 1 hour at room temperature with shaking.The plate is washed using a TITERTECK PLUS® plate washer with S20stacker with the washing buffer being PBS with 0.05% TWEEN® 20. Anenzyme conjugate of tacrolimus covalently coupled to glucose-6-phosphatedehydrogenase diluted in blocking buffer diluent to 1:4000 is added at100 μl per well. Incubation is performed for about 1 hour at roomtemperature with shaking. The plate is then washed and a chromogenicsolution is added at a volume of 100 μl per well. The chromogenicsolution contains 0.593 mM p-iodonitrotetrazolium violet, 0.02 M NAD,0.033 M glucose-6-phosphate, 0.055 M Tris, 0.02% sodium azide, and a1:4000 dilution of diaphorase (lipoyl dehydrogenase). BSA is present at1% (vol/vol) of a 5% w/vol BSA solution. BSA is used to help preventrapid precipitation of reduced p-iodonitrotetrazolium violet.

From the screening a hybridoma producing a suitable monoclonal antibodyis selected. This monoclonal is designated as the tag antibody becausethe antibody binds to both sirolimus and tacrolimus.

Example 2 Determination of Sirolimus Using Automated Chrome ParticleSandwich Assay

Preparation of anti-sirolimus F(ab′)₂-β-galactosidase conjugate using amonoclonal antibody that binds to domain D1 of sirolimus. Monoclonalanti-sirolimus antibody that binds to domain D1 of sirolimus (preparedas described above in Example 1) is fragmented to F(ab′)₂ usinglysyl-endopeptidase (Wako, Richmond, Va.) digestion and then isconjugated to β-galactosidase using a standard heterobifunctional SMCC(succinimidyl trans-4-(N-maleimidylmethyl)cyclohexane-1-carboxylate)linker according to known techniques. The antibody conjugate solutioncontains approximately 2.0 μg/mL anti-sirolimus antibody-β-galactosidaseconjugate, 30 mg/mL protease free bovine serum albumin, 0.126 mg/mLMgCl₂, 0.03 mL/mL of ethylene glycol, 24.5 mg/mL HEPES, 38.5 mg/mL NaHEPES, 50 mg/mL NaCl and beta-gal mutein (inactivatedbeta-galactosidase), pH 7.8.

Magnetic chrome particle preparation. Chrome particles (immunoassaysolid phase) are prepared by conjugating a monoclonal antibody thatbinds to domain D1 of sirolimus (prepared as described above in Example1 using as an immunogen C-26-Sirolimus Oxime-BSA Conjugate (Va) (R⁵=BSAin FIG. 6)) to glutaraldehyde coated chromium dioxide particles. Thechrome reagent contains chrome particles and 60.4 mg/mL trehalosedihydrate and 7.2 mg/mL polyethylene glycol (PEG) 8000. Three chromeparticle concentrations, namely 5, 2.5, and 1.67 mg/mL, are used in thestudy.

Sandwich sirolimus Assay. The principle and operation of the Sandwichassay for sirolimus is as follows: A whole blood sample (50 μL)containing sirolimus is combined with a hemolytic pretreatment reagentprepared as described above in a reaction vessel on the DIMENSION® RxLanalyzer. The whole blood is sampled from a standard cup by first mixingthe blood with the ultrasonic sample probe. The mixing of whole bloodsample with the pretreatment solution ensures the hemolysis of the wholeblood and the displacement of the protein-bound sirolimus molecules fromtheir binding domains.

Anti-sirolimus F(ab′)₂-β-galactosidase conjugate prepared using themonoclonal antibody that binds to the D1 domain of sirolimus (50 μL) isadded to the reaction vessels and the mixture is held for a period oftime (35 sec) and at a temperature of 43° C. to allow sirolimus, ifpresent, to react with the antibody enzyme conjugate. Chrome particleswith immobilized monoclonal antibody that binds to both tacrolimus andsirolimus are added (50 μL) to the reaction vessels and are allowed tobind the anti-sirolimus F(ab′)₂-β-galactosidase complex to form asandwich. This reaction mixture is incubated for 14 min at a temperatureof 43° C. before the automated magnetic separation, mix and wash cyclesbegin on the DIMENSION® instrument. A total of 4 separation/wash cyclesare employed to remove the unbound anti-sirolimusF(ab′)₂-β-galactosidase conjugate and debris from sample. The automatedchrome washes are conducted on board using Chemistry Wash solution at pH8.0 in HEPES buffer, both of which were provided for the DIMENSION®Heterogeneous Immunoassay Module. The washed chrome particles are thenre-suspended in the Chemistry Wash solution by ultrasound mixing and aportion (54 μL) of the suspended chrome particles are transferred to aphotometric cuvette to mix with a β-galactosidase substrate solution(chlorophenol red-β-D-galactopyranoside, or CPRG). The sirolimus boundto the anti-sirolimus F(ab′)₂-β-galactosidase conjugate on the chromeparticle surface is detected by measuring the enzymatic rate of theconjugate in the presence of CPRG. The rate for each reaction vessel ismeasured bichromatically at 577 and 700 nm. The results indicatesuccessful detection of sirolimus.

Example 3 Determination of Sirolimus Using Automated ELISA SandwichAssay

Sandwich enzyme-linked immunosorbent assay (ELISA) for sirolimus. Thefollowing steps are employed: Step 1: 50 μL of purified monoclonalantibody that binds to domain D1 of sirolimus (prepared as describedabove in Example 1 using as an immunogen C-26-Sirolimus Oxime-BSAConjugate (Va) (R⁵=BSA in FIG. 6)) (10 μg/mL in PBS) is coated on ELISAplates overnight at 4° C. Plates are washed using MILLI-Q® water(Millipore Corporation, Billerica Md.) containing 0.05% TWEEN® 20. Step2: 200 μL of PCT Blocker solution (0.5% Casein (milk protein) inphosphate buffer containing 0.05% TWEEN® 20) is added to each well andthe media are incubated at room temp for 30 min. Plates are washed usingMILLI-Q® water containing 0.05% TWEEN® 20. Step 3: 50 μL of desiredconcentration of sirolimus diluted in PBS is added to the respectivewells and the media are incubated at room temperature for 30 min. Platesare washed using MILLI-Q® water containing 0.05% TWEEN® 20. Sirolimusdrug concentrations tested are 0, 0.01, 0.02, 0.04, 0.08, 0.16, 0.31,0.63, 1.25, 2.50, 5.0 and 10.0 ng/mL, respectively. Step 4: Theanti-sirolimus F(ab′)₂-β-galactosidase conjugate prepared using themonoclonal antibody that binds to both tacrolimus and to sirolimus(prepared in a manner similar to that described above) (1:300 diluted inPCT Blocker solution) is added and the media are incubated at roomtemperature for 30 min. Plates are washed using MILLI-Q® watercontaining 0.05% TWEEN® 20. Step 5: β-galactosidase substrate solutionCPRG is added to each well (100 μL/well). Step 6: The wells are read inplate reader at 577 nm every minute for 20 min. The results indicatesuccessful detection of sirolimus.

All publications and patent applications cited in this specification areherein incorporated by reference as if each individual publication orpatent application were specifically and individually indicated to beincorporated by reference.

Although the foregoing invention has been described in some detail byway of illustration and example for purposes of clarity ofunderstanding, it will be readily apparent to those of ordinary skill inthe art in light of the teachings of this invention that certain changesand modifications may be made thereto without departing from the spiritor scope of the appended claims. Furthermore, the foregoing description,for purposes of explanation, used specific nomenclature to provide athorough understanding of the invention. However, it will be apparent toone skilled in the art that the specific details are not required inorder to practice the invention. Thus, the foregoing descriptions ofspecific embodiments of the present invention are presented for purposesof illustration and description; they are not intended to be exhaustiveor to limit the invention to the precise forms disclosed. Manymodifications and variations are possible in view of the aboveteachings. The embodiments were chosen and described in order to explainthe principles of the invention and its practical applications and tothereby enable others skilled in the art to utilize the invention.

What is claimed is:
 1. A method of determining a presence and/or amountof a small molecule having a molecular weight of about 500 to about2,500 in a sample suspected of containing the small molecule, the methodcomprising: (a) providing in combination in a medium: (i) the sample,(ii) a first binding partner that binds to and is specific for a firstportion of the small molecule, and (iii) a second binding partner thatbinds to the small molecule at a second portion of the small moleculeother than the first portion, wherein the second binding partner isprepared from an immunogen that comprises a hapten that is not the smallmolecule or a derivative of the small molecule wherein the haptencomprises a moiety that is structurally similar to that of the secondportion of the small molecule, (b) incubating the medium underconditions for binding of the first binding partner and the secondbinding partner to the small molecule, and (c) examining the medium forthe presence of an immunocomplex comprising the small molecule, thefirst binding partner and the second binding partner, the presenceand/or amount of the immunocomplex indicating the presence and/or amountof the small molecule in the sample.
 2. The method according to claim 1,wherein both the first binding partner and the second binding partnerare antibodies.
 3. The method according to claim 1, wherein both thefirst binding partner and the second binding partner are monoclonalantibodies.
 4. The method according to claim 1, wherein the smallmolecule is selected from the group consisting of immunosuppressantdrugs, cardiac glycosides, hormones and peptides.
 5. The methodaccording to claim 4, wherein the small molecule is an immunosuppressantdrug.
 6. The method according to claim 5, wherein the immunosuppressantdrug is sirolimus or everolimus.
 7. The method according to claim 6,wherein the hapten of the immunogen is tacrolimus or a derivativethereof.
 8. The method according to claim 1, wherein one of the firstbinding partner and the second binding partner comprises a member of asignal producing system.
 9. The method according to claim 1, wherein oneof the first binding partner and the second binding partner is bound toa support.
 10. A method of determining a presence and/or amount of animmunosuppressant drug in a sample suspected of containing theimmunosuppressant drug, the method comprising: (a) providing incombination in a medium: (i) the sample, (ii) a first antibody thatbinds to and is specific for a first portion of the immunosuppressantdrug, and (iii) a second antibody that binds to the immunosuppressantdrug at a second portion of the immunosuppressant drug other than thefirst portion, wherein the second antibody is prepared from an immunogenthat comprises a hapten that is not the immunosuppressant drug whereinthe hapten comprises a moiety that is structurally similar to that ofthe second portion of the immunosuppressant drug, (b) incubating themedium under conditions for binding of the first antibody and the secondantibody to the immunosuppressant drug, and (c) examining the medium forthe presence of an immunocomplex comprising the immunosuppressant drug,the first antibody and the second antibody, the presence and/or amountof the immunocomplex indicating the presence and/or amount of theimmunosuppressant drug in the sample.
 11. The method according to claim10, wherein both the first antibody and the second antibody aremonoclonal antibodies.
 12. The method according to claim 10, wherein theimmunosuppressant drug is selected from the group consisting ofsirolimus, everolimus, tacrolimus and cyclosporin.
 13. The methodaccording to claim 10, wherein the immunosuppressant drug is sirolimusor everolimus and the hapten of the immunogen is tacrolimus or aderivative thereof.
 14. The method according to claim 10, wherein one ofthe first antibody and the second antibody comprises a member of asignal producing system.
 15. The method according to claim 10, whereinone of the first antibody and the second antibody is bound to a support.16. A method of determining a presence and/or amount of animmunosuppressant drug selected from the group consisting of sirolimusor everolimus in a sample suspected of containing the immunosuppressantdrug, the method comprising: (a) providing in combination in a medium:(i) the sample, (ii) a first monoclonal antibody that binds to and isspecific for a first portion of the immunosuppressant drug, and (iii) asecond monoclonal antibody that binds to the immunosuppressant drug at asecond portion of the immunosuppressant drug other than the firstportion, wherein the second monoclonal antibody is prepared from animmunogen that comprises tacrolimus or a derivative of tacrolimus, (b)incubating the medium under conditions for binding of the firstmonoclonal antibody and the second monoclonal antibody to theimmunosuppressant drug, and (c) examining the medium for the presence ofan immunocomplex comprising the immunosuppressant drug, the firstantibody and the second antibody, the presence and/or amount of theimmunocomplex indicating the presence and/or amount of theimmunosuppressant drug in the sample.
 17. The method according to claim16, wherein one of the first monoclonal antibody and the secondmonoclonal antibody comprises a member of a signal producing system. 18.The method according to claim 16, wherein one of the first monoclonalantibody and the second monoclonal antibody is bound to a support. 19.The method according to claim 16, wherein the first portion consistsessentially of a triene portion of the immunosuppressant drug.
 20. Themethod according to claim 16, wherein the first monoclonal antibodyexhibits substantially no binding affinity for tacrolimus.